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Ballet Emmanuel
Grand Junction Workshop 2015
Tuesday, May 26th –Thursday, May 28th
Beginning—ages 4 to Adult
Times: Tues 26th and Wed 27th -9:30am to Noon (@River of Life)
Thurs 28th - 4:30pm to 7pm (@Lincoln Park Barn)
Concert: Thurs 28th @7pm (@Lincoln Park Barn)
Tuition: $30/dancer
Intermediate and Advanced –ages 10 to Adult
Times: Tues 26th and Wed 27th –1pm to 6pm (@River of Life)
Thurs 28th - 1pm to 3:30pm (@River of Life)
- 4:30 to 7pm (@Lincoln Park Barn)
Concert: Thurs 28th @7pm (@Lincoln Park Barn)
Tuition: $50/dancer
Registration and Tuition Due: Monday, May 11th
Concert: All participants will have the opportunity to perform in Ballet Emmanuel’s
concert “The Journey” on Thursday, May 28th @ 7pm
Workshop Location - River of Life Alliance Church: 701 24 1/2 Road, Grand Junction
Concert Location- Lincoln Park Barn: 910 North 12th Street, Grand Junction
www.BalletEmmanuel.org
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Ballet Emmanuel Workshop
Grand Junction 2015
Registration and Medical Release Form
Mail Registration Forms and Tuition to: Ballet Emmanuel 6547 N Academy Blvd #559, Colorado Springs, CO 80918
Dancer’s Name________________________________________________________ Age on date of the event __________________ Years of Dance__________________
Years of Ballet ______________ Dance Studio if Applicable______________________________________________________________________________________________
Parent’s Name________________________________________________________________________________________________________________ ___________________________
Address______________________________________________________________________________________________________________________ ____________________________
City____________________________________________________________________________________ State________________________ Zip___ ____________________________
Phone (__________)________________________________________
Email_______________________________________________________ ______________________________
Please tell us about any allergies, disabilities, or other concerns: ______________________________________________________________________________________
I understand that students are expected to maintain the highest standards of conduct at all times. As a participant in Ballet Emmanuel’s Workshop, I am willing to adhere
to the guidelines and rules of the program.
Student Signature ______________________________________________________________________________________________Date ___________________________________
I hereby certify that the applicant is in good health and acknowledge that the applicant will be dancing several hours during the Workshop. I agree that neither Ballet Emmanuel nor any of its staff is responsible for any injury or illness that may occur on the premises and/or during the Workshop.
Parent/Guardian Signature____________________________________________________________________________________ Date____________________________________
Photo and Video Release:
I ___________________________ (Parent’s name/Participant 18 yrs. or over) agree to allow photos/videos to be taken of ___________________________________
(my child/myself) and for the pictures to be used in Ballet Emmanuel’s promotion and publicity.
Parent/Guardian Signature______________________________________________________________________________________ Date____________________________________
Tuition: *Make checks payable to Ballet Emmanuel*
Beginning -Ages 4 to adult : $30/participant
Intermediate & Advanced -Ages 10 & up: $50/participant
Amount Paid: _________ Check #: ___________ or Cash